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Time Vs. Expertise

There is a story about a remote research facility that was having a problem with their generator. They tried to get a few technicians to fix it but it never worked right. Finally, they brought in an expert. The expert looked at the generator, tapped it twice and it ran perfectly. He sent the bill for $2002.00. When the scientists saw the bill they were incensed at the price for so little work on the part of the expert. They demanded an itemized statement. The expert sent one which read: $1.00 per tap x 2 taps = $2.00 + $2000 for knowing exactly where to tap.

I tell this story to help people understand that when you meet with an expert it is about their skills, knowledge, and experience, not their time. I have patients come in who are surprised at how much an adjustment costs considering how little time it takes. We are especially expedient in our office. To those patients I say, you are not buying our time, you are buying our expertise.

Most patients love that they can come into our office and get a great adjustment in a short amount of time. It does not take us long to figure out what is going on with a patient and adjustments by their nature are quick. We don’t do therapies like e-stim and ultrasound. We are not nutritional counselors. I have no problem with chiropractors who do that but that is just not how we choose to practice. We focus on giving good adjustments that help people with their busy lives.

In addition, the greatest benefit of chiropractic is not an adjustment but regular and consistent adjustments. We really encourage patients to get adjusted often and regularly by making it convenient and quick to come in. We also make it very affordable to get adjusted a lot. The price per adjustment if you just come in once in a long while is expensive. However, if you want to come in regularly, the price per adjustment is downright cheap in our office.

We will always strive to spend as much time as you need to give you a great adjustment. We are here to listen to your concerns. We never want patients to feel rushed. That saying, care in our office is not based on time. Care is based on service done with skill and care.

***Photo by Veri Ivanova on Unsplash

This Chiropractor’s Perspective on Mandatory Vaccination

I have stayed away from the topic of vaccinations in my practice because it is very emotional for both sides of the argument and it is not necessarily relevant to what I do as a chiropractor. However, this is more about freedom and healthcare and I am finally ready to share my thoughts. I know some of you will disagree on different points. To that, I say, great! Science is all about looking at an issue from several angles and sharing perspectives. Science does not own truth nor does it ever espouse it. Science seeks to hypothesize, observe under certain conditions, and theorize. That saying, I am very concerned with any side of an argument that claims to use science to hammer their agenda to the point of a mandate.

State Senator Richard Pan, who was a practicing pediatrician turned politic, has been working very hard to make vaccinations mandatory. I am sure he has his reasons and some of them may be pure but it also seems like he is being supported by those who stand to make a lot of money from the sale of these vaccinations. He started out a few years ago by passing a bill which made it illegal for parents to sign a vaccine waiver on grounds of religious or moral opposition which forced parents who are concerned about the damage a vaccine may cause to their child to get a waiver signed by a medical doctor. Now he is going after the medical doctors who signed those waivers and looking to establish a panel to overturn their opinions and make it harder, if not impossible, to get a waiver.

A few years ago, Senator Pan paraded several medical doctors who testified that they would sign waivers if they felt it was warranted. Apparently, that was a charade to pass that bill because now he does not want any individual doctor to have that kind of authority. Let’s be very clear, he is not interested in your research, your opinion, your morals, or your beliefs. Right now he is seeking to make it mandatory for all children who attend a public school to be vaccinated unless his handpicked panel decides otherwise. This is not about science, it is about control derived from money and power.

The argument for mandatory vaccines and the talking points behind them have spiraled to fear mongering. They use the theory of herd immunity as the basis of their argument. Herd immunity is the theory that if a high percentage of people are immune to a disease, presumably through vaccination, then the disease can be contained. It is not a terrible theory but there are holes in it. They also claim they need herd immunity to protect the children who cannot be vaccinated. They claim that we are putting these children at risk. Interestingly enough though, they make it sound as if unvaccinated individuals are the ones spreading the disease. This thought has been pervasive enough for the mayor or New York City to pass a decree that the unvaccinated are not allowed in the city or they will be fined.

To these points, I beg for a more scientific approach or just plain and simple logic. It is not an unvaccinated person who spreads disease but a person who has the disease. You cannot share something you don’t have or have never had. In fact, vaccinated children are 100% more likely to spread a disease they are vaccinated for than unvaccinated children. Within two weeks of being vaccinated for measles or chicken pox, there is a shedding period where the person can be contagious. It is rare but possible. Whereas, it is still impossible for an unvaccinated person without the disease to spread it.  Besides, if you have so much faith that vaccines work, why should you be worried if you and/or your kids are vaccinated? Finally, if you are worried about the children who are unvaccinated getting the disease, I can understand the concern from your perspective but are you willing to claim that your concern is greater than the parents’? Herein lies the debate. Do you have the right to act on your differing opinion on a child who is not yours?

Those who claim the moral high ground in favor of forced vaccinations are missing the greater points of liberty and the slippery slope that can lead to the loss of all freedom. I firmly believe that almost everyone should get adjusted on a regular basis and that society would benefit from it. Would you be comfortable with me pushing to pass a law that forced you to get your children adjusted regardless of your opinion about chiropractic? What if I was reasonable at first and just said they needed a couple of adjustments? What if later I told you they needed more? What if I said, at first, that you could get a waiver if your chiropractor (and only a chiropractor) said your bones were too brittle or you have joint laxity or some other condition that might cause harm, only to then tell you that your chiropractor is not qualified to make that decision and we need to have a panel of experts whom I choose to make that for them? At first blush, this is ridiculous, yet, we are at this point right now with our rights to choose the care we feel best for our children as the stakes.

If forced vaccinations for children going to school passes, what is next? Will this smarter-than-you panel of medical doctors then decide that adults must be vaccinated? Will they decide that you have no options? Will we start fining people as they have threatened in New York City? Does this sound like a conspiracy? It is! But unlike the people who are trying to convince you that the earth is flat, this conspiracy has a lot of money and power to back it up.

Again, my point is not whether you should or should not vaccinate your children. For what it is worth, my opinion is that vaccination started out as a pretty good idea. It was a risk vs. risk scenario. Introduce a little of a disease, let the immune system work its magic and create a great chance at immunity. The risk on both sides is always real. We have taken it too far, though. The pro-vaccine side seeks to dismiss any risk that the diseases, let alone the rest of the chemicals in the cocktail, pose any risk. Yes, those risks seem to be small but they are real. For some people, the risks are not only real but imminent. For those opposed to vaccines, they tend to inflate the risks. Most people who are vaccinated are not going to have a severe reaction. For those that have had severe reactions, however, it can be absolutely devastating.

I get that having the measles, mumps, rubella, diphtheria, tetanus, pertussis, chickenpox, shingles, polio, etc. can be very bad and even life-threatening. Step back from the fear and consider that the chance of infection is still very small in the United States and the risk of death is almost statistically completely improbable. Now, one can argue that it is because of the vaccines that these diseases are almost non-existent. That is a reasonable assumption but I can counter that disease comes and goes regardless. I had chicken pox as a kid. Almost everyone I know did. It wasn’t fun but it wasn’t deadly. Now, I am immune. If I keep my immune system in good shape, I will never get it, or shingles, again. No vaccine needed. Chickenpox was super rare when they came out with the vaccination. Since then, shingles and chickenpox (the same virus) have been on the rise. Maybe it is a coincidence but I reserve the right to scientifically observe to think otherwise. Observation takes time, by the way. It is OK to wait and test. There is no crisis. Furthermore, are you comfortable giving your infant a vaccine for a sexually transmitted disease like HPV or hepatitis because they may choose to be promiscuous when they are teenagers? I’m not. I would rather teach them the consequences of such actions and encourage proper behavior.

The argument as to whether you should or should not vaccinate your children based on the risks on both sides of the argument is a very personal decision and should be considered with much research. Unfortunately, the research is very thin. When, how much, and what kinds of vaccines a child needs, has changed with time not based on research but on theory. Either way, your right to do so or not should be unalienable. Forced vaccination raises the same ethical arguments of the Nuremberg Trials. I am far less concerned about the possibility of more disease or more injuries. Those will cycle. If you do your best to stay healthy, your risk for either is very low. I am much more concerned about the loss of freedom. What happens when you disagree with your doctor about a procedure for you or your child in the future? Will you be forced to do the procedure anyway? Will your child be taken from you? It sounds crazy but please consider that control is always the end game even if it sold for benevolent reasons.

***Photo by Hyttalo Souza on Unsplash

 

 

Chiropractic Adjustments Help the Autonomic Nervous System

The Autonomic Nervous System has two major components, the Sympathetic and the Parasympathetic. As the name implies, these systems work without thought. The Parasympathetic Nervous System controls digestion, reproduction, waste elimination, and rest. The Sympathetic Nervous System controls activity, stress, and adrenaline. The quick way to remember is that the Parasympathetic is rest and digest and the Sympathetic is fight or flight.

The two components work opposite of each other. When one is running the other defers. I like to compare it to kids on a see-saw. When one is up the other is down. When you have two relatively equal sized kids, the see-saw works well, same as a good balance in the Autonomic Nervous System. Problems arise with imbalance.

When a person has dysfunction in the spine it tends to increase Sympathetic flow. All of a sudden, we have a big kid vs. a small kid on the see-saw. With increased Sympathetic flow, the body stays in a state of agitation at the detriment to rest and digestion. This can lead to a multitude of conditions and symptoms.

Chiropractic adjustments help to restore function which helps to balance the Autonomic Nervous System. In this way, Chiropractic can help with conditions that are not musculoskeletal in nature. Chiropractors often get a bad rap for claiming to work on things like heartburn, indigestion, sleep, constipation, heart palpitations, vision issues, and the list goes on. The truth is that many of these conditions arise because of an imbalance to the Autonomic Nervous System. So, when your chiropractor asks, tell him about all of your symptoms and conditions.

3 Types of Chiropractic Care

Not everyone will fall into one of the categories specifically but, in general, there are three types of chiropractic care. The key is deciding what results you want from chiropractic care. From there, we can determine the frequency and mode of treatment.

The first type of care focuses on symptoms. A chiropractor will see you as many times as needed to reduce your symptoms to a level you can manage. This is usually short term care. Some people will stop here, deal with the manageable symptoms, and then come back when they flare up again. Pain, by the way, is the most common symptom but there are many others, as well, including, but not limited to, numbness and tingling, weakness, blurry eyes, tinnitus, heartburn, etc.

The second type of care takes into account the larger picture and seeks to restore function. I call this rehab or functional restoration care. The plan is generally the same for most people because restoring function is more predictable than reducing symptoms. While we restore function, symptoms will reduce naturally but we continue care to reinforce proper function and actual healing. Most people will need about three months of care. The frequency tends to be three times a week for about a month tapering down to twice a week for a month then once a week. By the end of three months, most people have healed enough to the point of feeling better and functioning as best as can be expected. There is variability in this care and some conditions take a lot longer.

The third type of care is maintenance. Once you have put so much effort and commitment into being your best, I feel it is best to maintain through consistent chiropractic care. Once a week is needed for some and some lucky patients can get away with once a month. Less than that and most patients are coming back with symptoms which begs the question if they are actually maintaining or just chasing their tale? We make maintenance a high priority in our office and make sure it extremely affordable.

Your results will depend on what type of care you engage and how consistently you are engaged in that care. You cannot get rehab results from a few visits of symptom care. Likewise, you cannot maintain something you have attained. Sometimes, patients want to negotiate to get rehab results by coming in once a week. I would love to be able to do that but that’s just not how the body works. For me, the ideal way to treat a patient who is injured or has chronic dysfunction is to complete a course of rehab care and follow it up with continuing maintenance care around once a week.

Back Pain and the Hip Flexor or Psoas

 

 

Often times, low back pain is exacerbated by a tight hip flexor, also known as the psoas. Getting adjusted can help reduce the stress on the psoas but sometimes you need a little more work in the form of a stretch. This video demonstrates how to stretch the difficult area. If the problem persists, we can do some myofascial work to break up adhesions. Look for a video of that in the not too distant future.

Chronic Back Pain Vs. Fibromyalgia

I have observed over the years that when patients are in chronic pain for a long time and seek help repeatedly from their medical provider, eventually, they will be diagnosed with fibromyalgia. Providers often diagnose patients with fibromyalgia as a way to encourage the patient to stop seeking care. The reality is that most of the time the provider does not have an adequate answer as to why a person has pain nor do they have any way to help. They label it, generically, as fibromyalgia. I empathize with these patients and their providers.

Fibromyalgia, one can argue, is not really a diagnosis but a description of symptoms. Etymologically, it means pain in the fibrous and muscle tissues. Most providers act like there is no real cause. Many providers assume the patient is either a symptom magnifier seeking drugs or just emotionally unstable. In my experience, more often than not, the real issue is chronic pain and can be traced back to a source with enough work. Finding the right professional to diagnose and then to treat can be daunting, however.

The causes and treatments for chronic pain are vast. Hope can be easy to sell but is often difficult to deliver. Possible causes can be osteoarthritis (wear and tear due to time or injury), auto-immune arthritis, chronic subluxations or joint dysfunction, poor posture, stress, muscle knots, referred pain from internal organs, hormone imbalances, etc., or a combination of all of the above. When I treat someone with chronic pain, I am not always successful. Sometimes, when I am successful, it may not be long-lasting. Most people I can ease some of their discomforts, at worst, or help them heal altogether. Patience and paying attention to subtle changes is the key to figuring out what is causing the pain.

It can be daunting to figure out a path to improvement. Chiropractic is a great place to start. If improving joint function and nerve flow helps, then keep going. If the help is only very temporary, like less than a couple of days of relief after months of care, then you may need to add massage or some other muscle or fascia work. After that, you will need to explore various internal issues. I would refer you to a good Naturopath or Functional Medical Specialist. Now you have to consider internal organ dysfunction. Gut issues are the most common. In addition, assessing hormone function is very important. Finally, do not rule out the psycho-somatic component. PTSD (Post Traumatic Stress Disorder) can make it so that healed physical pain lingers. The pain is no less real but one must manage their emotional issues before complete recovery is achieved. Temporal care along the way is still beneficial.

If you are suffering from chronic pain or have been diagnosed with Fibromyalgia, don’t be afraid to try a host of treatments. Start conservatively and work from there. Be wary of embellished claims of immediate or permanent relief but, also, don’t lose hope. At the very least, I am positive there is someone who can help you manage your pain.

***Photo by Jesper Aggergaard on Unsplash

 

 

5 Causes of Sciatica

Sciatic Back Sciatic NerveFirst, let us define what sciatica actually is and is not. Sciatica is, very specifically, pain along the sciatic nerve stemming from irritation of that nerve. The sciatic nerve is formed from a conglomeration of spinal nerves in the low back which binds together into one sheath. This nerve runs under the piriformis muscle in the pelvic area, then runs in between the two parts of the biceps femoris, also known as the hamstrings. It has become common to call any pain in the leg which is suspected to come from the back, sciatica. However, sciatica is a nerve pain which is the same feeling you get when you hit your “funny bone.” Most leg pain, and consequently what most people call sciatica, is actually referred pain. That is a different post. To be a true diagnosis of sciatica, it must be nerve pain that stems from the lumbar spine and runs into the buttock and/or down the backside and middle of the thigh. Now that we have that out of the way, let’s talk about what causes it!

  1. Disc Injury. Disc injuries are the most common back ailment. When a disc bulges or herniates, it can occupy the space where the spinal nerves exit from the vertebral column. If a disc bulges too far it can push against the nerve root causing pain to travel down the sciatic nerve and beyond. Sometimes, the bulge will hit the nerve and then pull back enough so that the sciatic pain is not constant. If the disc is in constant contact with the nerve, one can experience pain, numbness and tingling, weakness, and other symptoms. Chiropractic can help, but these can take a long time to heal and consistency makes the difference. Traction, rehabilitation exercises, physical therapy, and stretching can also help if done properly. If it comes to it, cortisone injections and surgery may be last resort options.
  2. Inflammation. With injury comes inflammation. Though the disc is the most common injury, there are several other structures in the area of the nerves that make the sciatic nerve that can be injured. Inflammation is toxic and can cause its own set of issues. Nerves are especially sensitive to inflammation. Icing, NSAIDs like ibuprofen, Chiropractic, and steroids can all help reduce inflammation. When the inflammation is in check, the back and sciatic pain will diminish. When the area with the sciatic nerve or nerve root is inflamed. The symptoms will remain constant.
  3. Sacro-Iliac (SI) Joint Dysfunction. The sciatic nerve crosses the SI Joint just after it forms the large nerve. If the pelvis shifts or is not working properly, it can irritate the Sciatic Nerve through direct pressure, inflammation, or by causing muscle tightness or spasms from the imbalance. Adjusting the SI joint will help reduce inflammation and muscle guarding, as well as move it away from contact with the nerve if that is the case. Chiropractic is by far the best thing for this case but a clever physical therapist can help, too. Exercise, stretching, and icing may help but can irritate it, as well.
  4. Piriformis Syndrome. This diagnosis has become pretty popular. I find that it is misdiagnosed more often than not. The piriformis is a little pear-shaped muscle (hence the name, piri means pear), that spans the SI joint. The Sciatic Nerve runs underneath it in most individuals. If this muscle tightens, it can compress the sciatic nerve and cause sciatica. The piriformis can tighten for various reasons including any of the above-mentioned maladies. Usually, I find the piriformis is a secondary issue. Sometimes, however, it can take on a life of its own after the other condition has resolved. If it is, truly, piriformis syndrome, the best thing to do is have a specialist perform a muscle release on it. Active release, myofascial release, Bowen, Rolfing, massage, etc. can all help if done right. Be aware that if it only helps for a little while, then there is probably another issue that is still causing the muscle to tighten or guard.
  5. Direct Contact. Because the Sciatic Nerve runs through the buttock and down the back of the leg, the way one sits can cause sciatica. The most common cause is a wallet in the back pocket. Additionally, a seat that curves upward along its lip can put pressure on the legs and irritate the nerve. Unfortunately, I have seen this most often in vehicles.  The solution for these is obvious. The trick is to figure it out before it causes problems more difficult to remedy.

There you have it. Probably not a comprehensive list but definitely the most common causes. Sciatica is actually rarer than it seems. When you have it, however, it is very painful and can be difficult to treat. If you are experiencing sciatica or any type of pain or other symptoms down the leg, chiropractic can help. And, like all conditions, being prompt and consistent makes for better and quicker healing.

5 Things to Do When a Rib “Goes Out”

Rib HeadsRib pain can be miserable. I cannot tell you how many patients have come in to see me after visiting the Emergency Department because they suspected a heart attack or something serious. Pain in the chest, shortness of breath, radiating pain down the arm, nausea, etc. Sounds like a heart attack but all of the tests are negative. So what do you when the emergency docs send you home and tell you it is nothing? Most likely you are dealing with a rib that is either stuck or not moving in the way it is supposed to. Here are five things to do, and not to do, to help.

  1. Heat and Ice. One of the biggest complaints, when a rib is out, is muscle spasming. Heat will help you endure a muscle spasm. There is a caveat, however. Heat brings blood to an area and if that blood is not flushed out, it will cause more inflammation. So, use heat for 20 minutes and then walk around for a while or ice it. Ice drives away inflammation. Ice for 20 minutes maximum. Always end with icing. For more information on heating and icing, go here.
  2. Massage, but be careful. As mentioned, muscles are often tight when a rib is not functioning properly. massage can really help to calm down the muscles. Here again, a word of warning. Often times, the person giving the massage will feel a good sized bump and mistake what is really the head of the rib for a muscle knot. Rubbing this bump will not only be painful but can increase symptoms. Working on the areas around it can be quite helpful. Massaging after the rib is moving again is great.
  3. TENS or Electric Stimulation. A great, non-drug option for killing a spasm and managing pain is to use e-stim, TENS or something similar. These are basically devices that send electrical pulses through wires and patches over muscles. There are several options of machines and can be purchased at various locations or from Amazon. Price and quality range drastically but I have found that the inexpensive units work pretty well.
  4. Get it adjusted! At the end of the day, until the rib starts moving properly it will cause problems. Not all chiropractors are great at adjusting ribs as they can be difficult. Likewise, you really need to have the specific rib adjusted and not just do a general spine adjustment. Even after you get it adjusted it may still feel out. Remember that the muscles have most likely tightened around it and formed a knot. Symptoms can take a while to settle down.
  5. Mind your posture and quit trying to stretch it. Typically, ribs go out because of a forward head and shoulder posture. So, why do we always try and stretch that same way to get it to feel better? Likewise, stretching spasming muscles does not really work. It drives me crazy when I adjust a rib and the first things my patient does is check to see if stretching forward still hurts. That is like separating a wound to see if it has healed yet. If you keep doing it, it will never heal. Instead, look straight ahead and pull your shoulder blades down and back. Here is the vintage YouTube video I created to demonstrate. If you do this exercise and it is still really painful, chances are the rib is out again.

Ribs can definitely be tricky. Sometimes they stay in after one adjustment and sometimes they take several adjustments. Usually, the longer it is out the more adjustments it will take. The rib joints at the front where it connects to the sternum can go out, too. These are also very painful and can be adjusted, although it is a different method. Please remember that although rib pain is brutal, it is not that damaging. Stressing about it will only complicate the healing process. If you have pain to one side of the spine by the shoulder blades, in the front next to the sternum, radiating along the ribs, or all of the above, just come in and we can either help you or, at least, point you in the proper directions.